National health research system in Malawi: dead, moribund, tepid or flourishing?
Identifieur interne : 001517 ( Main/Exploration ); précédent : 001516; suivant : 001518National health research system in Malawi: dead, moribund, tepid or flourishing?
Auteurs : Joses Muthuri Kirigia ; Damson D. Kathyola [Malawi] ; Adamson S. Muula [Malawi] ; Martin Matthew Okechukwu OtaSource :
- BMC Health Services Research [ 1472-6963 ] ; 2015.
Abstract
Several instruments at both the global and regional levels to which countries in the WHO African Region are party call for action by governments to strengthen national health research systems (NHRS). This paper debates the extent to which Malawi has fulfilled this commitment.
Some research literature has characterized African research – and by implication NHRS – as moribund. In our view, the Malawi government, with partner support, has made effort to strengthen the capacities of individuals and institutions that generate scientific knowledge. This is reflected in the Malawi national NHRS index (MNSR4HI) of 51%, which is within the 50%-69% range, and thus, it should be characterized as tepid with significant potential to flourish. Governance of research for health (R4H) has improved with the promulgation of the Malawi Science and Technology Act in 2003. However, lack of an explicit R4H policy, a strategic plan and a national R4H management forum undermines the government’s effectiveness in overseeing the operation of the NHRS. The mean index of ‘governance of R4H’ sub-functions was 67%, implying that research governance is tepid. Malawi has a national health research focal point, an R4H program, and four public and 11 private universities. The average index of ‘creating and sustaining resources’ sub-functions was 48.6%, meaning that R4H human and infrastructural resources can be considered to be in a moribund state. The average index of ‘producing and using research’ sub-functions of 50.4% implies that production and utilization of research findings in policy development and public health practice can best be described as tepid. Efforts need to be intensified to boost national research productivity. Over the five financial years 2011–2016 the government plans to spend 0.26% of its total health budget on R4H. The mean index of ‘financing’ sub-functions of 23.6% is within the range of 1-49%, which is considered moribund.
A functional NHRS is a prerequisite for the achievement of the health system goal of universal health coverage. Malawi, like majority of African countries, needs to invest more in strengthening R4H governance, developing and sustaining R4H resources, and producing and using research findings.
Url:
DOI: 10.1186/s12913-015-0796-1
PubMed: 25889757
PubMed Central: 4392748
Affiliations:
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Kathyola</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Ministry of Health, Department of Research, Lilongwe, Malawi</nlm:aff><country xml:lang="fr">Malawi</country><wicri:regionArea>Ministry of Health, Department of Research, Lilongwe</wicri:regionArea><wicri:noRegion>Lilongwe</wicri:noRegion></affiliation></author><author><name sortKey="Muula, Adamson S" sort="Muula, Adamson S" uniqKey="Muula A" first="Adamson S" last="Muula">Adamson S. Muula</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Community Health, Faculty of Public Health and Family Medicine, College of Medicine, Blantyre, Malawi</nlm:aff><country xml:lang="fr">Malawi</country><wicri:regionArea>Department of Community Health, Faculty of Public Health and Family Medicine, College of Medicine, Blantyre</wicri:regionArea><wicri:noRegion>Blantyre</wicri:noRegion></affiliation></author><author><name sortKey="Ota, Martin Matthew Okechukwu" sort="Ota, Martin Matthew Okechukwu" uniqKey="Ota M" first="Martin Matthew Okechukwu" last="Ota">Martin Matthew Okechukwu Ota</name><affiliation><nlm:aff id="Aff1">Research, Publications and Library Services Programme, Health Systems and Services Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo</nlm:aff><wicri:noCountry code="subfield">Congo</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Health Services Research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Several instruments at both the global and regional levels to which countries in the WHO African Region are party call for action by governments to strengthen national health research systems (NHRS). This paper debates the extent to which Malawi has fulfilled this commitment.</p></sec><sec><title>Discussion</title><p>Some research literature has characterized African research – and by implication NHRS – as moribund. In our view, the Malawi government, with partner support, has made effort to strengthen the capacities of individuals and institutions that generate scientific knowledge. This is reflected in the Malawi national NHRS index (MNSR4HI) of 51%, which is within the 50%-69% range, and thus, it should be characterized as tepid with significant potential to flourish. Governance of research for health (R4H) has improved with the promulgation of the Malawi Science and Technology Act in 2003. However, lack of an explicit R4H policy, a strategic plan and a national R4H management forum undermines the government’s effectiveness in overseeing the operation of the NHRS. The mean index of ‘governance of R4H’ sub-functions was 67%, implying that research governance is tepid. Malawi has a national health research focal point, an R4H program, and four public and 11 private universities. The average index of ‘creating and sustaining resources’ sub-functions was 48.6%, meaning that R4H human and infrastructural resources can be considered to be in a moribund state. The average index of ‘producing and using research’ sub-functions of 50.4% implies that production and utilization of research findings in policy development and public health practice can best be described as tepid. Efforts need to be intensified to boost national research productivity. Over the five financial years 2011–2016 the government plans to spend 0.26% of its total health budget on R4H. The mean index of ‘financing’ sub-functions of 23.6% is within the range of 1-49%, which is considered moribund.</p></sec><sec><title>Summary</title><p>A functional NHRS is a prerequisite for the achievement of the health system goal of universal health coverage. Malawi, like majority of African countries, needs to invest more in strengthening R4H governance, developing and sustaining R4H resources, and producing and using research findings.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Pang, T" uniqKey="Pang T">T Pang</name></author><author><name sortKey="Sadana, R" uniqKey="Sadana R">R Sadana</name></author><author><name sortKey="Hanney, S" uniqKey="Hanney S">S Hanney</name></author><author><name sortKey="Bhutta, Za" uniqKey="Bhutta Z">ZA 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Muthuri" last="Kirigia">Joses Muthuri Kirigia</name><name sortKey="Ota, Martin Matthew Okechukwu" sort="Ota, Martin Matthew Okechukwu" uniqKey="Ota M" first="Martin Matthew Okechukwu" last="Ota">Martin Matthew Okechukwu Ota</name></noCountry><country name="Malawi"><noRegion><name sortKey="Kathyola, Damson D" sort="Kathyola, Damson D" uniqKey="Kathyola D" first="Damson D" last="Kathyola">Damson D. Kathyola</name></noRegion><name sortKey="Muula, Adamson S" sort="Muula, Adamson S" uniqKey="Muula A" first="Adamson S" last="Muula">Adamson S. Muula</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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